Nursing in a New Language

UAB Reaches Out Around the World

By Doug Gillett

UAB School of Nursing student Michelle Blackburn in Honduras

While most of Birmingham was sound asleep at 2:30 a.m. on Thursday, May 28, Lygia Holcomb, D.S.N., C.R.N.P., was awakened by an earthquake in Santa Rosa de Copan, Honduras—another reminder, as if she needed one, that her dozens of trips to Central America over the past 12 years have been anything but vacations.

“The power went out immediately, as soon as things started shaking,” Holcomb remembers. “The bridges were out; the roads were torn up. We thought about trying to get out, but when we found out how difficult it would be to get to the airport, we decided we would just continue with our plans as best we could. We had a cold breakfast of tortillas and went on about our business.”

Holcomb’s story is emblematic of the mindset that has driven the UAB School of Nursing (SON) to establish partnerships in numerous low-resource countries in recent years. Faculty and students don’t just visit for a few days and go home. The point is to develop sustained relationships with nursing schools and health-care networks that offer long-term benefits for UAB nursing students, faculty nurses, and health-care workers overseas.

“We wanted commitment,” says SON assistant professor Karen Saenz, Ph.D., M.P.H., M.S.N., C.P.N.P., a veteran of the school’s outreach efforts in Latin America. “We wanted to stay, and the new dean—Dr. Doreen Harper—and all of the leaders at the School of Nursing told us, ‘We’ll commit to this, too. If you go, then we’ll give you the time to establish relationships and develop plans for future educational programs.’ And they did.”

Honduras: A Two-Way Street

School of Nursing students and faculty in Honduras. Lygia Holcomb is at far left, Karen Saenz at far right (click to see larger version of photo).

Saenz and Holcomb already had made numerous visits to Honduras when they joined the UAB faculty five years ago. The SON had identified Honduras as a priority country, as had the Pan-American Health Organization (PAHO), WHO’s regional division for Latin America and the Caribbean.

For three years, SON faculty have been bringing groups of students to a small nursing school in the western Honduran city of Santa Rosa de Copan for nine or 10 days at a time. For part of the trip, students work with and observe nurses and social workers in the city, getting a firsthand look at both the sparse resources available to Honduran caregivers and the resourcefulness those health-care workers exhibit as a result.

“The hospital is set up as big wards—30 beds in a room, one after another,” Holcomb explains. “On the end of each bed, there’s a chart with the patient’s information—and there are no curtains between the beds. It’s a very different system but very caring and professional. And they do it all themselves; the nurses and doctors don’t have a lot of ancillary staff.”

The SON students and faculty members also make trips into the countryside to deliver health care directly to people living in remote rural areas. “A lot of times we have to go in the back of a pickup truck, wandering down narrow dirt roads with cows coming up to the back of the truck and licking you, but it’s a wonderful model of what community and public-health nursing is all about,” Saenz says.

The SON representatives bring valuable resources and treatment innovations when they travel to Honduras, but they receive equally valuable instruction from their hosts as well. “We aren’t going down there and showing them how to do everything,” Saenz says. “They show us quite a bit. They have excellent assessment skills, for one, because they have to get by on the bare minimum without all the technology that we have. Our students return to the United States and continually draw on their experiences.”

Participants in the SON's Strengthening Honduran Families project with nursing faculty at the University of Honduras (click to see larger version of photo)

As beneficial as the student visits are, they’re just the start of an intensive, long-term collaborative relationship between the SON and Honduras, says Lynda Wilson, Ph.D., R.N., F.A.A.N., assistant dean for international affairs and deputy director of the school’s PAHO/WHO Collaborating Center for International Nursing. Using a grant from the Sparkman Center on Global Health, former SON professor Ellen Buckner, D.S.N., R.N., purchased computers and Internet access—a rare commodity in Honduras—for both the nursing school and the hospital in Santa Rosa de Copan so that nurses there can maintain communication with UAB faculty and students. And while the student trips have been part of an elective course at the SON, Wilson says the school is exploring ways to allow students to do some of their required clinical hours in community health and obstetrics in Honduras.

“What we’re talking about is something that could really give students some excellent clinical experiences while building on the school’s missions of service, education, and research in Alabama and beyond,” Wilson explains. “The school’s strategic plan articulates our commitment to partnership and collaboration, not only at home but abroad via our collaborating center.”

Zambia: Building a Nursing Force from the Ground Up

On the opposite side of the world, the sub-Saharan African nation of Zambia faces a similar dearth of resources but different health issues. The most overwhelming, clearly, is HIV/AIDS. Although the United States committed $15 billion through the President’s Emergency Plan for AIDS Relief in 2003 to provide Africa with drugs and education, those resources opened up a new set of challenges—how are they to be distributed in a country like Zambia, where there are only 12 doctors for every 100,000 patients?

UAB nursing faculty and members of the curriculum group in Zambia. Lynda Wilson is second from left (click to see larger version of photo).

UAB has had a presence in Zambia for about eight years through the Center for Infectious Disease Research in Zambia. In 2006, SON dean Doreen Harper, Ph.D., R.N., F.A.A.N., asked Wilson to travel to Zambia to find ways for nurses to play a role in the country’s battle against HIV. In just three years, the partnership between the SON and Zambia’s Ministry of Health has paid off with a wealth of innovative projects, including a program to teach nurses how to provide HIV drugs and a novel method of delivering computer-based HIV information to nurses in rural areas with limited Internet access. (To learn more, see “Zambian Innovation.”)

“I’m delighted,” Wilson says, “to have partnered with medicine, nursing, and other health professions programs to build nursing capacity in order to improve the health of the people of Zambia.”